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Buried Penis in Children

​What is a buried penis?

The penis is wrapped in a sheath of skin. Usually, the skin is evenly distributed around the entire penis, down to the scrotum. However, some boys are born with skin that unevenly covers the penis. There is less skin on the part of the penis closest to the scrotum. The penis also hides within the fat inside the lower part of the belly. This is called a ‘buried penis’. Doctors also call it hidden or concealed penis.

In most children, buried penis is a condition that will get better by itself. 

Boys are born with a buried penis (congenital). There can be many causes, which include:

  • problems with the skin and fat layers surrounding the penis of a developing fetus.

  • too much fat on top of pubic bone, which is common in young babies.

  • not enough skin on the side of the penis that faces the scrotum (scrotal “webbing”).

     
Buried Penis
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If the skin covering the penis is unevenly distributed, the penis can appear buried, or concealed. It can also hide under the fatty layers surrounding it (pre-pubic fat pad). A buried penis usually gets better by itself. In some cases, it may require surgery.

At what age does buried penis occur?

Doctors can usually diagnose buried penis in babies up to 2 years of age.

What are the signs of buried penis in babies?

  • Often, parents are concerned because the penis seems too small. It may also complicate proper hygiene

  • The foreskin may puff and expand when the baby urinates. If this happens constantly, babies may dribble urine continually. Also, the child may have trouble directing their stream properly while toilet training.  

Adolescents with buried penis are usually obese. Older children are usually referred to treatment because of cosmetic reasons. An adolescent with a buried penis may experience:

  • pain or difficulty urinating (dysuria). Inflammation of the foreskin (balanitis) can also happen.

  • trouble directing their urinary stream because of difficulty holding the penis

  • embarrassment in the locker room.

  • difficulty with proper hygiene.

Treatment for buried penis

Most cases of buried penis do not require any sort of treatment. It usually improves spontaneously over time.

The buried penis can be successfully treated by:

  • applying the anti-inflammatory medicine, betamethasone, to the area.

  • manually pulling the foreskin several times each day.

Many different surgical techniques can also help. One surgical option is circumcision during the first month after birth. Talk to your child’s doctor to learn about possible treatment options for your child.

What are the possible surgical complications?

There are few complications. If they do occur, most are temporary.

  • During the healing process, scar tissue inside the skin can sometimes stick together (adhesions). Or, extra connective tissue can build up (fibrosis). Both can pull the penis back in again and bury it.

  • Swelling of the penis

  • Pain during an erection

  • Poor graft healing, flap necrosis or complaints of decreased sensitivity in the grafted area.

  • Persistent overgrowth of the skin covering the penis

  • Belly fat re-accumulates

Buried penis can cause emotional distress in children

Children with buried penis are at risk for psychological and social trauma. Obese boys with a buried penis may feel ashamed of their bodies. As a result, they withdraw socially. Surgery may relieve anxiety and improve self-image. However, it is a good idea for parents to first encourage obese boys with buried penis to lose weight before committing to surgery.  

Key points

  • The penis is usually wrapped in a sheath of skin.

  • Buried penis happens when the skin unevenly covers the penis. The penis also hides within the fat inside the lower part of the belly. 

  • Doctors diagnose buried penis in babies up to the age of 2 years old.

  • Adolescents may experience pain or difficulty urinating, trouble directing their stream, and trouble with proper hygiene.

  • In most cases, buried penis will improve spontaneously over time.

  • Treatment options include surgery, applying bethamethasone cream, and manual pulling the foreskin every day.

  • Buried penis can cause emotional distress in children.

​Dalia Bozic, RN, MN, NP-PHC

Rodrigo Romao, MD

3/6/2012





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